Health Organizations Research Articles

Learning from the pandemic: Building capacity for risk communication in the Canadian federal health portfolio.

The federal health portfolio has had a risk communications framework in place since 2006; however, the COVID-19 pandemic pushed the capacity of this plan and the need for communications resources to new levels. Health communicators in the public service face significant challenges: a fragmented mediascape, changes to how people seek and use information, the proliferation of misinformation and disinformation, declining trust in public institutions, and the politicization of science, to name just a few. It has never been more important for health authorities to communicate clearly, consistently, effectively, and from an evidence-based position. This report describes one aspect of how the federal health portfolio has been addressing these challenges. As part of a recent capacity-building initiative, 67 public servants working in health communications participated in a four-part, half-day, advanced seminar series at Carleton University in June 2023. Each session featured an interactive presentation from a leading scholar and/or local practitioner with real-world scenario exercises designed to put their learning into practice. The series explored issues in trust and transparency, algorithmic control and mis- and disinformation, media relations, and risk communication for equity-deserving populations. At the conclusion of the program, participants were given tools to (1) identify challenges to effective communication brought by a rapidly evolving media environment in which skepticism and misinformation often run rampant; (2) examine how key metrics and behavioural indicators on social media platforms demand different responses from health organizations and agencies who are monitoring and managing social media; (3) consider challenges for health communicators who must serve the public during health crises while also reinforcing public trust in their institutions; and (4) develop successful risk communication strategies for equity-deserving communities by considering specific information needs and tailored dissemination methods to reach the intended audience. Participants expressed high levels of satisfaction in the quality of the training and overwhelmingly reported that it would positively impact their daily work. The training program was an innovative and successful initiative to improve knowledge of current priority topics and best practices in risk communication. It illustrated the benefits of continued professional learning, the importance of university-public service partnerships, and how capacity building requires ongoing resource commitments and engaged support from senior management. The program, along with other risk communication training that is currently being implemented, is part of the investment in long-term professional development of risk communicators in the health portfolio.

Prevalence of and risk factors for cutaneous leishmaniasis in East Africa: a systematic review and meta-analysis

BackgroundCutaneous leishmaniasis (CL) is a neglected skin disease that affects millions of people worldwide. Its visible symptoms and impact on physical appearance can lead to social rejection, stigma, and discrimination for patients with cutaneous leishmaniasis. It is a public health and social problem in East Africa. However, there was no conclusive evidence on the pooled prevalence of cutaneous leishmaniasis in East Africa. Thus, we conducted a systematic review and meta-analysis to examine the current evidence on the burden of cutaneous leishmaniasis in East Africa.ObjectiveThe main purpose of this study was to estimate the pooled prevalence of cutaneous leishmaniasis and its risk factors in East Africa.MethodsThis systematic review and meta-analysis were conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Stata software version 17. A forest plot and a random effects model were used to estimate the pooled prevalence of CL with a 95% confidence interval (CI) and heterogeneity of articles, respectively.ResultsA total of 221,365 study participants were included in the review. Based on the results, the forest plot was explained by I2 = 99.99% at p < 0.05. The prevalence of cutaneous leishmaniasis in primary studies ranged from 0.73% to 79.10%. The pooled prevalence of CL in East Africa was found to be 22.57% with a 95% CI (14.36, 30.78). The effect size showed statistically significant subgroup effects for study design, study setting, sample size, clinical forms of CL, year of publication, and study period at p < 0.05 according to the subgroup analyses.Conclusion and recommendationsThe pooled prevalence of cutaneous leishmaniasis in East Africa was high. This underscores the urgent need for targeted public health initiatives to mitigate the impact of this disease on affected populations. Collaborative efforts between governments, health organizations, and communities are crucial for the effective management and control of CL in the East Africa region.Systematic review registrationhttps://www.crd.york.ac.uk, identifier CRD42024576017.

'Come and work here!' a qualitative exploration of local community-led initiatives to recruit and retain health care staff in remote and rural areas of the UK.

The recruitment and retention of health care staff to remote and rural communities is a major challenge. This study explored the experiences of remote and rural communities in trying to attract and retain health care staff and their families in the UK. Qualitative case studies in five remote and rural communities, two in England and three in Scotland. We conducted interviews with 22 participants across the five sites, including community members actively involved in recruitment and retention, health care professionals, and their family members. Fieldwork combined remote and in-person data collection. We used thematic analysis across cases drawing on asset-based community development as our theoretical framework. Communities undertook various activities such as making promotional videos, social media campaigns, getting involved on interview panels, and informal social integration efforts. They drew on a range of local assets to encourage health care staff to come to the area, including showcasing local landscapes, outdoor activities, a safe, welcoming community for children and families, and good quality of life. They also drew on the skills of local people with backgrounds in marketing, design, communications and photography or film-making. The absence of some key assets posed challenges, particularly lack of housing, schooling provision, employment opportunities for other family members, and cultural activities. Community-led initiatives were often prompted by local dissatisfaction with health organisations' efforts to recruit health care staff, and a wish to exercise some control over recruitment initiatives. Activities were commonly driven by a small number of individuals. While this worked well in some communities, the burden of responsibility could be substantial. This also sometimes led to tension within communities. Retention efforts commonly relied on informal networks of key individuals who intentionally forged social links for incoming families. There is a key role for communities to play in recruitment and retention in remote and rural regions. There is an opportunity to actively engage community members in collaboratively crafting a campaign that highlights the area's key attractions while being mindful of limitations on reliance on an asset-based approach. Retention is a neglected topic, relying on key individuals going out of their way to help newcomers integrate. The formation of a community stakeholder group could help formalise this and reduce reliance on the goodwill and energy of individuals.

The Biological Rationale for Integrating Intrinsic Capacity Into Frailty Models

The Biological Rationale for Integrating Intrinsic Capacity Into Frailty Models

Local Culture in the Dynamics of Islamic Religious Organizations (Study on Muhammadiyah Branch of Padang Lawas Utara District)

Muhammadiyah is one of Indonesia's most prominent Islamic religious organizations, growing rapidly as a leading religious organization in health and education. This research examines the challenges faced by the Muhammadiyah branch in the Padang Lawas Utara district. This study explores the dynamics between Muhammadiyah's institutional practices and the cultural frameworks within which they operate. The study utilizes a case study method to provide an in-depth understanding of the interactions between Muhammadiyah's organizational practices and local cultural elements. Data collection involves semi-structured interviews with key informants, participant observation, and document analysis of relevant organizational records and cultural artifacts. Data analysis was conducted using thematic analysis. A triangulation method is employed to ensure the validity and reliability of the data. The findings indicate that while local traditions can enhance the acceptance of Muhammadiyah's reformist ideals, they can also present challenges when cultural norms conflict with the organization's objectives. They are reluctant to accept the Muhammadiyah ideology due to the incompatibility between local culture and Islamic teachings.

A comparative analysis of transformational and transactional leadership styles in maximizing productivity and reducing burnout with sustainability

The intricate interaction between leadership styles and their impacts on organizational productivity and the health of employees, particularly in the health sector, has to be critically studied. In this study, the impact of transformational and transactional leadership styles on organizational productivity and sustainable workplaces will be explored. Inspirational and visionary transformational leadership is likely to boost productivity and reduce burnout among employees through a cohesive and creative organizational environment. Transactional leadership with an emphasis on effectiveness and clear exchanges for compliance is likely to enhance productivity in the short run but maybe boost burnout unless it is complemented by sustainable interventions. Through the incorporation of sustainability as a moderator, this research will explore how sustainability can boost the strengths of transformational leadership or overcome the weaknesses of transactional leadership in health organizations in Khyber Pakhtunkhwa, Pakistan. This research will apply quantitative techniques to measure the direct impact of these leadership styles and the moderating influence of sustainability programs and aim to provide actionable recommendations for enhancing the effectiveness of leadership in yielding high productivity and resilient employees.

An individual’s trust in government is a major determinant in the decision to voluntarily join a public health initiative

BackgroundRecently, there has been a growing trend of incorporating technology using health applications by official organizations such as health organizations and governmental bodies. In response to the COVID-19 pandemic, Israel implemented a health application to be voluntarily downloaded by citizens (VA). Additionally, the Israeli authorities used mandatory mobile tracking to monitor citizens’ movements (GT). The current study aims to identify the factors associated with individuals’ decisions to download the voluntary contact-tracing app. We hypothesized that (a) attitudes toward GT will mediate the relations between trust in the healthcare system and downloading VA, and (b) attitudes toward GT will mediate the relations between the perceived COVID-19 threat and downloading VA.MethodsData were collected among 741 respondents who completed an online survey on July 19–21, 2020. The survey was designed to represent the diversity of the Israeli population. A logistic regression was calculated with downloading VA as the dependent variable and trust in the healthcare system, perceived threat and attitudes toward GT as independent variables. Then, the extent to which attitudes toward GT mediated the associations between trust in the healthcare system and downloading VA and between the perceived threat and downloading the voluntary app was assessed using the Process procedure.ResultsThe findings reveal that 47.1% of respondents perceive governmental tracing as an invasion of privacy, while 24.4% report that it increased their sense of security. About a third report having downloaded the voluntary app. Both research hypotheses were supported; attitudes played a mediating role in the relationship between an individual’s level of trust and an individual’s level of perceived threat and behavior, i.e., higher trust and higher perceived COVID-19 threat were associated with more favorable attitudes towards GT, which was associated with more substantial odds of downloading VA.ConclusionsThe results emphasize the crucial importance of public trust. Building trust with the public is essential to encourage voluntary actions that ultimately benefit public health. Achieving and maintaining the public’s trust requires addressing concerns about the potential misuse of government power and fostering an environment that promotes voluntary participation and engagement.

Public interest in online searching of asthma information: insights from a Google trends analysis

BackgroundGoogle Trends (GT) is a free tool that provides insights into the public’s interest and information-seeking behavior on specific topics. In this study, we utilized GT data on patients’ search history to better understand their questions and information needs regarding asthma.MethodsWe extracted the relative GT search volume (RSV) for keywords associated with asthma to explore information-seeking behaviors and assess internet search patterns regarding asthma disease from 2004 to 2024 in both English and Persian languages. In addition, a correlation analysis was conducted to assess terms correlated with asthma searches. Then, the AutoRegressive predictive models were developed to estimate future patterns of asthma-related searches and the information needs of individuals with asthma.ResultsThe analysis revealed that the mean total RSV for asthma-related keywords over the 20-year period was 41.79 ± 6.07. The researchers found that while asthma-related search volume has shown a consistent upward trend in Persian-speaking countries over the last decade, English-speaking countries have experienced less variability in such searches except for a spike during the COVID-19 pandemic. The correlation analysis of related subjects showed that “air pollution”, “infection”, and “insomnia” have a positive correlation with asthma. Developing AutoRegressive predictive models on retrieved Google Trends data revealed a seasonal pattern in global asthma-related search interest. In contrast, the models forecasted a growing increase in information-seeking behaviors regarding asthma among Persian-speaking patients over the coming decades.ConclusionsThere are significant differences in how people search for and access asthma information based on their language and regional context. In English-speaking countries, searches tend to focus on broader asthma-related topics like pollution and infections, likely due to the availability of comprehensive asthma resources. In contrast, Persian speakers prioritize understanding specific aspects of asthma-like symptoms, medications, and complementary treatments. To address these divergent information needs, health organizations should tailor content to these divergent needs.

Stakeholder analysis of tobacco control policy in Iran: a qualitative study

BackgroundTobacco control in low- and middle-income countries is a complex issue due to powerful economic and political bodies in the production and distribution of tobacco products. The urgent need for effective tobacco control measures is highlighted by the rising health burden associated with tobacco use in Iran, necessitating a comprehensive stakeholder analysis. The current study aimed to analyze the roles and characteristics of all stakeholders involved in tobacco control policymaking in Iran.MethodsAdhering to the theoretical framework introduced by Varvasovsky and Brugha, a qualitative stakeholder analysis was conducted based on five items of stakeholders’ roles, interests, positions, powers and influences. The actors included in the study encompassed governmental bodies, non-governmental organizations (NGOs), the tobacco industry, health organizations, and the international community. The data were collected using semi-structured interviews with 36 key informants. MAXQDA V.10 software was used to analyze interviews by content analysis, and PolicyMaker software V.4 was used to perform data analysis.ResultsForty-two tobacco-related stakeholders were identified and classified into eight groups of governmental executives, legislative body, non-governmental organizations, mass media, universities, clerics and imitators, the tobacco industry, and international organizations. The Iranian Parliament and public sector stakeholders have the central role in all stages of the policymaking process. The state actors prevail in all stages of Iran’s tobacco control policymaking. The number of non-governmental organizations active in the field of tobacco control was limited. Notably, there exists a conflict of interest between the actors in the two areas of tobacco control and the tobacco industry. Health-related organizations in Iran exhibit a weak coalition for tobacco control, lacking influence over the tobacco industry and smuggling control actors, while various stakeholders have diverse interests impacting their relationships.ConclusionStrengthening the government’s tobacco control capacity and developing a national tobacco control strategy, in which intersectoral collaboration between different actors is established, can reduce the conflict of interests between involved actors in Iran. This, in turn, leads to a reduction in the smoking rate and an improvement in public health in Iran.

Learning Together to Think Critically About Health Information

This participatory case study investigates how collaborative learning can enhance critical health literacy, which is instrumental for making informed health decisions, managing, and preventing health problems. Data collection sources include participant observations, interviews, and project documents, which will be analyzed using deductive-inductive thematic analysis. The study focuses on one case – a group that meets regularly online, hosted by an independent community library in Montreal, Canada. As this is research in progress, preliminary findings will be shared. Ultimately, this community-based project will provide useful insights to community partners, librarians, health organizations, and educators.

Delayed Transition to 20-Valent Pneumococcal Conjugate Vaccine in Pediatric National Immunization Programs: Forgone Public Health and Economic Benefit.

Despite the approval of a 20-valent pneumococcal conjugate vaccine (PCV20) for pediatric use in many regions globally, integrationof PCV20 into national immunization programs (NIPs) is delayed in some countries. We explored the public health and economic benefits forfeited by postponing transitions from lower-valent pneumococcal conjugate vaccines (PCVs) to PCV20. A targeted literature review (TLR) identified modeling studies comparing the public health and economic impact of PCV20 versus 13-valent PCV (PCV13) or 15-valent PCV (PCV15) in pediatric NIPs. Only studies with accessible models underwent data extraction and analysis. Foregone public health (pneumococcal disease cases/disease-related deaths) and economic (medical/non-medical costs) outcomes, defined as the projected incrementaldifferences between the outcomes associated with PCV20 and lower-valent PCVs, were calculated over 2years following PCV20 implementation (per year and month). Discount rates for all outcomes were adjusted to 0% given the short timehorizon and for consistencyacross analyses. The TLR identified models from 13 countries globally. The monthlyhealth benefits forgone due to delayed transitions from PCV13 to PCV20 ranged between 40 (Slovakia) and 1740 (Canada) pneumococcal disease cases avertedin the first year of delay across populations, increasing by between 1.5 (Sweden) and 15-16 times (Germany and Mexico) in the second year. Forgone cumulative disease-related deathsaverted ranged from 18 (Spain) to 2657 (Germany) and forgone cumulative direct medical cost-savings ranged from 930 thousand Euros (Portugal) to 146million Euros (Germany) due to delayed transitions from PCV13 to PCV20 over 2years. Similar, but slightly reduced, benefits were forfeited with delayed transitions from PCV15 to PCV20. Delays in implementing PCV20 into pediatric NIPs were projected to have substantial negativepublic health and economic consequences. These results underscore the necessity for national immunization technical advisory groups, policymakers, health organizations, and manufacturers to accelerate replacement of lower-valent standard-of-care PCVs with PCV20.

Influenza Vaccination Rates, Perceptions, and Vaccine Hesitancy in K-12 Teachers and Staff

BACKGROUND: Vaccination misinformation can contribute to vaccine hesitancy and decreased vaccination. Previous immunization events at various K-12 schools carried out by Idaho State University L.S. Skaggs College of Pharmacy have noticed a small turn out of teachers and staff getting immunized during these events. Given the prominent role that teachers/staff serve in communities, we surveyed K-12 teachers and staff to determine their perceptions, knowledge, and reasons surrounding vaccine hesitancy. Our survey focused on the influenza vaccine, but also inquired about vaccine knowledge in general. METHODS: A Qualtrics survey was distributed online throughout the West Ada School District, located in southwestern Idaho. Demographics, receipt of vaccine, influenza vaccination motivation, knowledge and reasons for hesitancy were collected. Surveys were distributed July 2020 and analyzed using descriptive statistics. Response differences between those who most recently received their influenza vaccine and those who did not were also compared using chi-square or Mann-Whitney U tests when appropriate. RESULTS: A total of 503 surveys were completed, with all respondents college educated and teaching throughout the K-12 curriculum. A majority of respondents (n=409;81%) received a yearly influenza vaccination. Reasons for vaccination included: avoidance of flu, reduction of spread, and prevention of complications. Reasons against vaccination included: lack of efficacy, side effects, and numerous “other” responses. When comparing general influenza vaccine knowledge between those who received their influenza vaccine vs. those that did not, those who had been vaccinated displayed responses that more closely coincided with scientific data. CONCLUSIONS: The majority of surveyed K-12 teachers/staff received their influenza vaccine during the 2019-2020 season. However, ~20% of teachers/staff are still hesitant due to misinformation regarding vaccinations. Resources and partnerships between health organizations and school districts may increase vaccine acceptance.

Environment, Climate, and Diabetes: An International Topic.

Every person with diabetes is affected by changes in the environment and climate. At the same time, the therapy of many people itself has a negative impact on these factors. One might assume that the relevant professional associations and health organizations, as well as health policymakers, have initiated appropriate activities. The manufacturers of antidiabetic drugs and medical devices used in diabetes therapy are aware of the problems at hand. To what extent they really implement changes in the production, storage, and transport of their products is not easy to assess. In summary, it should be said that the importance of environmental factors for people with diabetes and their therapy is probably still not sufficiently recognized.

Rapid Adaptation to Prevent Drug Use (RAPD): protocol of a pilot randomized trial to enhance the impact of an evidence-based intervention for youth

BackgroundDrug use trends change rapidly among youth, leaving intervention experts struggling to respond promptly. Delays in responses can lead to preventable morbidity and mortality. The COVID-19 pandemic underscored the need for implementation science to facilitate rapid, equitable responses using existing treatment and prevention efforts. Existing, widely adopted evidence-based interventions (EBIs; e.g., the Michigan Model for Health™: MMH) are well suited to address emerging drug trends. We have a critical need to advance implementation strategies to optimize system responsiveness to these emerging drug issues. This research aims to design and test implementation strategies to (1) improve the responsiveness of school-based EBIs in addressing urgent issues and (2) find ways to support teachers in implementing updated EBIs, attending to unique considerations of schools serving economically disadvantaged students.MethodsThe research aims are as follows: aim 1: identify implementation gaps and best practices using After Action Review (a reflective process used by health organizations in responding to emergent public health events) using qualitative methods. Aim 2: design and pilot test RAPD (Rapid Adaptation to Prevent Drug use) based on aim 1 findings. RAPD refers to a novel set of implementation strategies designed to enhance the capacity of an existing, widely adopted evidence-based universal prevention curriculum (MMH) to respond to emerging drug issues among youth. We will pilot test RAPD in ten middle schools serving diverse student populations using a two-group, mixed method, cluster randomized controlled trial design. Aim 3: assess the costs and benefits of RAPD from multiple partner perspectives using a mixed methods approach.DiscussionThis study focuses on designing and deploying implementation strategies to reduce the detrimental impact of emerging drugs and provide an infrastructure to make future adaptations that can be applied in other contexts. After Action Review (AAR) provides a valuable opportunity to review the statewide response to past drug use events, specifically the vaping crisis, using the MMH curriculum, which can systematically guide implementation strategy selection and deployment to meet identified gaps. The rationale for the proposed research is that designing and testing RAPD will advance implementation science in responding to urgent public health events and ensure equitable responses across youth populations.Trial registrationClinicalTrials.gov NCT05806840.

Health-Related Advertising: Leveraging Virtual and Human Influencers to Encourage Health Behaviors

Previous studies have explored the importance of health-related advertising; however, effective social media advertising strategies for promoting health behaviors remain poorly understood. Grounded in construal level theory, the current study examines the impact of influencer types (virtual vs. human) on health behavior types (illness prevention vs. illness detection). The results indicate that pairing virtual (human) influencers with illness prevention (illness detection) enhances the effectiveness of health promotion (Studies 1 and 2). This effect is driven by increased self-efficacy and reduced fear. Specifically, in the condition of illness prevention, virtual influencers are found to be more effective in increasing individuals’ self-efficacy and, consequently, help-seeking intention. However, in the illness-detection condition, human influencers proved to be more successful in reducing fear, which subsequently improved help-seeking intention (Study 3). This study enriches the literature on health-related advertising, influencer marketing, and construal level theory, offering governments, health organizations, and enterprises valuable guidance on using virtual influencers for successful health-related advertising.

Vitamin D: Evidence-Based Health Benefits and Recommendations for Population Guidelines.

Vitamin D offers numerous under-recognized health benefits beyond its well-known role in musculoskeletal health. It is vital for extra-renal tissues, prenatal health, brain function, immunity, pregnancy, cancer prevention, and cardiovascular health. Existing guidelines issued by governmental and health organizations are bone-centric and largely overlook the abovementioned extra-skeletal benefits and optimal thresholds for vitamin D. In addition, they rely on randomized controlled trials (RCTs), which seldom show benefits due to high baseline 25-hydroxyvitamin D [25(OH)D] concentrations, moderate supplementation doses, and flawed study designs. This review emphasizes the findings from prospective cohort studies showing that higher 25(OH)D concentrations reduce the risks of major diseases and mortality, including pregnancy and birth outcomes. Serum concentrations > 30 ng/mL (75 nmol/L) significantly lower disease and mortality risks compared to <20 ng/mL. With 25% of the U.S. population and 60% of Central Europeans having levels <20 ng/mL, concentrations should be raised above 30 ng/mL. This is achievable through daily supplementation with 2000 IU/day (50 mcg/day) of vitamin D3, which prevent diseases and deaths. Furthermore, a daily dose between 4000 and 6000 IU of vitamin D3 to achieve serum 25(OH)D levels between 40 and 70 ng/mL would provide greater protection against many adverse health outcomes. Future guidelines and recommendations should integrate the findings from observational prospective cohort studies and well-designed RCTs to improve public health and personalized care.

Learning and Organisational Change in Regional Agencies of Telemedicine: Implications for the Mexican Case

The aim of this article is to analyse the technological and organisational learning processes and their relationship with organisational and institutional changes in Mexican public hospitals that have implemented telemedicine systems. A qualitative research strategy has been followed by implementing an exploratory multiple-case-study approach. The fieldwork was conducted from July 2012 to June 2015 in seven regional agencies of telemedicine (RATM) of Mexico. General information for each RATM has been updated to 2021. The implementation and use of systems of telemedicine in clinics and hospitals around the world have influenced the efficiency and effectiveness of health services, but the effects are not direct or automatic. Health organisations go through phases of internalisation of technology and this implies the development of a knowledge base, learning processes and organisational and institutional changes. The processes of learning-by-doing, learning-by-implementing and learning-by-using explain the patterns of organisational and technological change. However, there are cultural and technical constraints that make these changes slow. A natural tension between the changes achieved and the prevailing resistances is present, so the role of leaders, the creation of scenarios that foster collaboration, trust and good communication among the members of the team, a knowledge base and learning processes are crucial.

A systematic literature review of real-world evidence (RWE) on post-market assessment of medical devices.

The increasing use of real-world evidence (RWE) and real-world data (RWD) to assess post-market medical devices (MDs) might satisfy the urgent need for data sharing and traceability. This study sought to (i) get an overview of current practice in post-market assessments of MDs reporting on RWE/RWD; (ii) draw policy recommendations for governments and health organisations and identify a research agenda for scholars.A systematic review was undertaken until February 2024 following the PRISMA guidelines. Original peer-reviewed articles in English and incorporating RWE/RWD into any sort of post-market assessment strategy for an MD were included and their reference lists manually checked. A narrative synthesis was employed to describe evidence retrieved.Totally, 145 research articles were identified. Administrative databases were mostly utilised; clinical and/or economic evidence gathered in a short/medium time horizon the most frequently reported; other evidence types (e.g., organisational) underreported; patient perspectives rarely incorporated; the innovation complexity of MDs relatively low.To our knowledge, this study is the first in its kind to provide a comprehensive picture of how non-randomised evidence has been used when assessing MDs working in real-life conditions. The implications of this review might help health policy scholars in addressing the avenues for research in RWE for MDs and policy-makers to better understand the risks and benefits of medium and long-term use of MDs alongside clinical practice and make more informed decisions about adoption and use.

A Novel Tool to Communicate the Needs of Survivors of Trauma to Health Professionals: A Mixed Methods Pilot Study.

To explore the acceptability and feasibility of using a trauma-informed communication tool to convey client needs to health professionals; and to understand the barriers and enablers for clients using the tool. Mixed methods design pilot study conducted by nurses from a regional community health service in Victoria, Australia, of purposively sampled clients who have a history of sexual assault and/or family violence and clinicians from a primary care service. The investigators developed a pocket-sized communication card to convey clients' history of trauma and the clients' emotional and physical needs to health care providers. Pre-intervention and post-intervention surveys using validated scales ('Acceptability of Intervention Measure' and 'Intervention Appropriateness Measure') were administered via anonymous online or paper-based survey. Sixteen clients completed the pre-intervention survey and 12 clients completed the post-intervention client survey. Seven Nurses and three Social Workers completed the clinician survey. Both clients and clinicians reported high rates of acceptability and appropriateness of the tool on the outcome measures. The most commonly reported barriers to using the tool were clients forgetting to use the card and concern about how health professionals may respond. Content analysis of qualitative data revealed themes categorised as positive impacts (prevention of re-traumatisation), negative impacts (negative response from health professionals) and suggestions for improvement of the tool (developing a digital version, raising clinicians' awareness of the tool). This novel tool has demonstrated a high degree of acceptability and applicability in a sample of clients with a history of trauma secondary to sexual assault and/or family violence, and community health clinicians, and several positive and negative impacts have been identified. Further research should focus on larger participant numbers and include developing a digital version and a clinician education component. Use of a tool to communicate impacts of trauma may prevent re-telling of traumatic stories by clients and enhance quality of care delivery. The Good Reporting of a Mixed Methods Study (GRAMMS) has been used to report the results of this study. During development of the tool, it was reviewed by a lived experience consumer representative, the health organisations' consumer advisory panel, and a small sample of clients.

Mental Health and Well‐Being Support for Individuals Living With Skin Conditions: A Global Landscape Analysis of Patient Needs and Current Resources

ABSTRACTThe impact of skin diseases can be devastating, encompassing physical symptoms such as bumps, rashes, hyper‐ or loss of pigmentation, redness, itch, pain and scarring. The consequences on mental health and well‐being are often more detrimental, impacting the ability to conduct routine daily activities and engage socially. Given the prevalence of dermatological conditions, it is critical that resources are available to address these needs. We conducted a review of dermatology patient advocacy groups and health organizations’ websites to determine what types of resources to support mental health and well‐being currently exist globally for individuals with skin conditions and identified 26 websites featuring resources such as sections dedicated to providing mental health information, programs on mental health topics and coping strategies, peer support forums, and counselling. Clinical trials and observational studies have demonstrated that many of these tools improve key mental health and well‐being‐related symptoms. In order for new and existing resources to be effective on a global scale, they should be delivered through methods that are sensitive to a spectrum of mental health‐related stigma, and cultural beliefs. In parts of the world where individuals value privacy above openly speaking about one's feelings, or where smartphone adoption is ubiquitous (i.e., Europe, South‐East Asia), digital health resources might hold the most potential for uptake. In regions such as Africa, and remote and rural Western Pacific, task‐shifting, a process whereby laypeople are trained by health professionals to deliver community‐based interventions, may be a promising format given mental health professional shortages. To provide optimal support for the mental health and well‐being of those around the world with skin conditions, future efforts should focus on evaluation of the patient benefits offered by existing resources, and their adaptation and expansion to befit other world regions, and align with varied cultural needs and beliefs.